Individual provider Active NPI

John Scrivano, PA-C

  • Physician Assistant
  • Escondido, CA
National Provider Identifier
1235224395
Registry record updated Dec 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA14455 Issued in CA
Practice address
306 W El Norte Pkwy Ste S
Escondido, CA 92026-1960
Phone
(760) 291-6700
Fax
(760) 746-5313
NPI assigned
Oct 4, 2006
Last updated
Dec 12, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA14455 CA Primary

Addresses

Primary practice location

306 W El Norte Pkwy Ste S
Escondido, CA 92026-1960

Mailing address

225 E 2ND Ave
Escondido, CA 92025-4249
Phone (760) 291-6700

Other identifiers 1

IdentifierTypeStateIssuer
PA14455OtherCALICENSE #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101215001040 CA Practitioner - Physician Assistant 6709074800 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Graybill Medical Group IncGroup PAC ID 9335050517, 103 clinicians

Practice addresses (Care Compare)

225 E 2ND Ave
Escondido, CA 92025-4212
Phone (866) 228-2236

306 W El Norte Pkwy
Suite S
Escondido, CA 92026-1960
Phone (760) 746-3703

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA14455CAMDPhysician Assistant

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733961600000",
    "number": "1235224395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 E 2ND AVE",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920254249",
            "telephone_number": "760-291-6700",
            "fax_number": "760-737-7324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 W EL NORTE PKWY STE S",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920261960",
            "telephone_number": "760-291-6700",
            "fax_number": "760-746-5313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCRIVANO",
        "first_name": "JOHN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA14455",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE #",
            "identifier": "PA14455",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Escondido, CA

Sources for this page

Verify at the official NPI Registry.